She pushed her arm under the pillow and pulled the covers over her head.

The blinds remained closed and the room gray, even though the clock was approaching 11 a.m. Saturday.

Feelings of hopelessness and inexplicable sadness streamed through her mind as she closed her eyes in the silence.

It's difficult for others to understand the struggle she experiences to get out of bed some mornings or why she simply can't choose to be happy, she said.

That's what they told her the first time she struggled with depression eight years ago.

Since then, Garcia, 29, has experienced several bouts of depression. In public, she puts on a strong face.

At home, in private, she desires to disappear. She wants to sleep all day and call in sick to work.

Holding her pillow that Saturday morning more than a month ago, Garcia heard a whisper.

She said it was the voice of God telling her to get out of bed and keep her plans to attend a friend's afternoon graduation.

"I listened to the Lord that day, and I got out of bed. I'm so glad I did because I went to the graduation, and it lifted my spirits so much. I can look at that down moment now and see how I was being sidetracked by the devil," said Garcia, a nondenominational Christian and Faith Family Church member.

Garcia's mental health paradigm has shifted in recent months. She voluntarily enrolled in Christian counseling this year and decided to renew her prescriptions for antidepressants.

She's battled depression many times, but this time she's coupling her faith, the power of God's healing and traditional medicine.

"This is what I needed to do this time," she said. "And so far, it's working. I can really tell there's a difference."

In some Christian circles both locally and nationwide, medication and therapy is considered, by some, controversial for treating mental health disorders. Some church bodies and pastors assert that if God is the ultimate healer, outside treatment with medication and counseling isn't needed for treating mental health issues.

Mental health issues are seen, rather, as a spiritual issue. They can be treated with more faith and more prayer.

Like many area residents seeking professional counseling for depression and other psychological issues, Garcia realized there's nothing wrong with seeking treatment outside the church.

"I decided there is nothing to be ashamed of if I need extra help right now. I was trying so long to do it on my own, and that didn't work," she said. "If I was diabetic, I would take insulin. Taking medication for depression is the same thing."

Garcia confessed it hasn't always been easy to openly discuss her depression. Friends and family never understood her troubles and always seemed to dismiss her feelings.

"I was embarrassed about admitting I was depressed. I had battled with it in the past, and based on the response I got, I didn't want to come forward. They kept telling me, 'Don't worry, you'll get over it,'" she said.

She was timid, at first to bring the issue to church, but once she started sharing her troubles with counseling sessions in small groups and with church friends, she started meeting others with similar problems.

"That's been really helpful because we can talk about it and pray with each other," she said. "It's been helpful to me to discuss it with them because we share stories, and we share prayer, and they help me learn how to give it to the Lord and have him take the depression from me."

Garcia's therapist, Loraine Turner, a licensed counselor with South Texas Children's Home Ministry in Victoria, has counseled Garcia for the past month.

Turner, 41, works with area churches to provide Christian counseling services at no cost for area residents.

"If we could go outside and see the dots over everyone's head who has had therapy or taken medication for depression or anxiety, people wouldn't feel so alone or feel afraid to seek counseling," Turner said. "It's much more common that people think, we just don't talk about it enough."

Turner said she supports all forms of counseling, but for those needing a biblical perspective in their treatment, she recommends Christian counseling to ensure the treatment is in line with the person's Christian beliefs.

Though she doesn't recommend medication for all of her patients, or even a long-term treatment plan, she said the church needs to get better at recognizing and discussing that it is needed for some patients.

"Depression in particular is more difficult than people realize. There really is some truth to the fact that there is a chemical imbalance when you're depressed. Your neurons don't always connect where they're supposed to," Turner said. "When medication is used for the people who need it, it helps them because there is a biological and physiological component to their situation."

Turner said many of her clients are aware of the stigma that exists in churches regarding mental health treatment. She said they often confide in her during session that they don't want to go to therapy because they fear how their church friends and family will label them.

"People are reluctant to come to therapy because they think others will think they're crazy or their faith isn't strong enough or they're not strong enough," she said. "That isn't true. ... We always tell them that we deal with normal people who have normal problems."

Lucy Holder, a licensed secular counselor with Reclamation Counseling Center, is also a Christian. She counsels patients in a more traditional format, but said she often hears about the importance of spirituality during sessions.

She's been counseling in Victoria for about 20 years and visits weekly with clients dealing with a range of issues from depression to drug and alcohol addictions.

When treating Christian clients, she, too, said her clients often mention they feel inadequate for seeking therapy.

"Some of them think they're not good enough because if they were, their prayers would have been answered," Holder said.

The stigma about mental health issues is easing from generations past, Holder said, but there is a long future ahead before people feel comfortable discussing their psychological problems in church.

Holder said she's been to Alcoholics Anonymous meetings where the people were more open and honest than most of the churches she has attended in her lifetime.

"Because many people think you have to be 'better than' at church and put on your best face," she said. "I think when we can be as open and honest in church groups as people are in therapy that would be terrific."

The Rev. John Woods, of Northside Baptist Church, said mental health issues have long had a stigma in the church. People don't always feel comfortable discussing their problems, or seeking therapy because they're afraid others might think they're not spiritual enough.

"In general, the church at large has discounted the profession of mental health counselors. For us at Northside, we think counseling can be really redemptive, whether its just therapy or using medication or both," he said.

Woods said the primary reason the stigma about mental health issues and treatment has persisted is because the church isn't talking about mental wellbeing enough.

"Part of it is that we don't talk about it, so it becomes a secret and taboo," Woods said. "Mental health issues should be considered the same as issues of physical health. You would go to the doctor if you were physically unwell, so we shouldn't have shame for wanting wellness in either area."

Garcia said her combined prayer and counseling treatments in recent weeks have allowed her some relief from the depression.

She's taking a 100 milligram antidepressant each day and said her goal is to wean off the drugs in the future.

She's optimistic that this time she will overcome her depression. She clinging to her faith, but she's also allowing herself to use the resources and knowledge of God's people.

"Some might not need it, but there is no shame or embarrassment in realizing you need help," she said. "I know for me personally, I needed the extra help."